Let's compare intravenous metoprolol to sodium thiopental and see how they compare. Sodium thiopental is used for euthanasia, Metoprolol? No, actually, intravenous metoprolol is so safe that internists are encouraged to administer it intravenously during an acute MI and it has been shown to reduce the risk of death in this situation. Do you loose consciousness with the agent? Sodium thiopental Yes, metoprolol NO. Can you loose the airway, stop breathing, collapse hemodynamically, and require a special residency and special clinical privileges to administer the drug? Sodium thiopental? Yes, metoprolol NO. Metoprolol is so safe compared to other agents anesthesiologists use every day that fear of the agent is not reasonsable. If you can administer sodium thiopental or propofol or a narcotic you can easily and safely administer metoprolol. It slows the heart rate. Let's compare it to fentanyl. Fentanyl slows the heart rate, stops breathing, depresses consciousness, and blunts pain. Metoprolol just slows the heart rate. Be not afraid of metoprolol or atenolol. They are your friends.